Organization
CACHE VALLEY DENTAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY LARSON DDS (OWNER/REGISTERED AGENT)
(435) 232-1232
Entity
Organization
Contact information
Practice address
120 W CACHE VALLEY BLVD STE 200, LOGAN, UT 84341-2697
(435) 753-7563
Mailing address
2797 N HIGHWAY 89 STE 300, PLEASANT VIEW, UT 84404-1232
(801) 786-0500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/15/2019
Last updated
04/15/2019
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